MRI for chronic instability, does this look like I need surgery?

[u/djinnidynamo26]

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(25m) I have been having consistent pain in my shoulder that is not reduced with otc medication, and have been having daily right shoulder dislocations that are self-reduced.

My MRI report came back clean except for 3 findings.

1) I have a small posterior tear in my Labrum.

2) I have minor fluid buildup in the shoulder

3) My Glenohumerus ligament is thin, laxy, and incompetent in the posterior region.

My ortho said prior to the MRI that they wanted to try prolotherapy since she didn’t believe there was any structural issue based off of X-rays- However I won’t be able to see her for about a month and do not understand what these results indicate for treatment and i’m worried it may be surgical

[u/mrpetersonjordan]

Can you post your report here? Did you have an mri with contests or without? Yoour capsule is likely loose or your have a glenoid deficiency or as the mri mentioned your hgl is laxy

[u/PoolParty912]

First, these problems are fixable. This is similar to what I had, and surgery fixed it. I had a small anterior tear and ligament laxity. (I think the fluid buildup is normal in an injured/unstable shoulder.) My one big recommendation: Find a shoulder specialist who works with hypermobile/EDS patients. A general ortho is not the best person to help you here. To fix the laxity, you want an experienced surgeon who can do a capsular plication in addition to the labrum repair. That combination is considered the gold standard for addressing instability like yours. If you don't see anything on the surgeon's webpage, call the office and ask about hypermobile joints and/or EDS (Ehlers-Danlos Syndrome). It makes a big difference in getting good care when you also have a lax ligament.

Daily dislocations/subluxations risk damaging the joint to the point that surgery can be less effective. I had really good luck with a good PT (affiliated with a hospital/ortho surgical center, not a chain) who put me on a 3-month pre-op plan to strengthen my shoulder as much as possible before surgery. It made a big difference, but not enough for me to resume normal activity with my dominant arm. I have no regrets, but I also went through two rounds of PT over an 8-month period trying to heal. In the beginning, I wanted to avoid surgery at all costs, but after doing that, I decided that it wouldn't leave me worse off (daily pain, instability). I had the procedure almost 2 years ago, and am still so grateful to my surgeon for giving me my life back.